Conspiracy theories have been proliferating during the COVID-19 pandemic. Evidence suggests that belief in conspiracy theories undermines engagement in pro-health behaviors and support for public health policies. Moreover, previous work suggests that inoculating messages from opinion leaders that expose conspiracy theories as false before people are exposed to them can help to prevent belief in new conspiracies. Goals of this study were to: (a) explore associations between COVID-19 conspiracy beliefs with SARS-CoV-2 vaccine intentions, cooperation with public health recommendations, and support for public health policies among U.S. adults and (b) investigate trusted sources of COVID-19 information to inform strategies to address conspiracy beliefs. A cross-sectional, online survey was conducted with 845 U.S. adults in April 2020. Data were analyzed using analyses of variance and multivariable regressions. One-third (33%) of participants believed one or more conspiracies about COVID-19. Participants who believed conspiracies reported that their intentions to vaccinate were 3.9 times lower and indicated less support for COVID-19 public health policies than participants who disbelieved conspiracies. There were no differences in cooperation with public health recommendations by conspiracy belief endorsement in the multivariable regression analysis. Although there were some key differences in trusted sources of COVID-19 information, doctor(s) were the most trusted source of information about COVID-19 overall with 90% of participants trusting doctor(s). Doctor(s) may play a role in addressing COVID-19 conspiracy theories before people are exposed to them to promote COVID-19 prevention efforts.

Testing for COVID-19 is important for identifying, tracing, and treating COVID-19 cases as well as informing policy decisions. Evidence from other disease epidemics suggests that anticipated stigma and stereotypes are barriers to testing for disease. Anticipated stigma may undermine testing due to labeling avoidance (i.e., efforts to avoid receiving the label of a stigmatized status) and stereotypes may undermine testing by reducing perceived vulnerability to disease. Given the importance of scaling up COVID-19 testing, the current study explored the potential roles of anticipated stigma and stereotypes in COVID-19 testing. A cross-sectional, online survey was conducted with 845 United States adults in April 2020. Measures were adapted from previous studies of stigma associated with infectious diseases, and participants were asked about the likelihood that they would seek a COVID-19 test if one were to be ordered by their doctor. Analyses demonstrated that participants who anticipated greater COVID-19 stigma and endorsed COVID-19 stereotypes to a greater degree reported that they would be less likely to seek a COVID-19 test. Notably, endorsement of anticipated stigma and stereotypes was low, and knowledge and fear were stronger predictors of testing than stigma. Nonetheless, results provide preliminary evidence that anticipated stigma and stereotypes may represent barriers to testing in the context of COVID-19, similar to other diseases. As COVID-19 tests become more widely available, efforts may be needed to address COVID-19 stigma alongside other barriers such as access and knowledge to maximize testing efforts.

Stigma changes over time: it waxes and wanes through history, is manifested within humans who develop over time and is tied to statuses (such as attributes, illnesses and identities) that have varying courses. Despite the inherent fluidity of stigma, theories, research and interventions typically treat associations between stigma and health as stagnant. Consequently, the literature provides little insight into when experiences of stigma are most harmful to health and when stigma interventions should be implemented. In this Perspective, we argue that integrating time into stigma research can accelerate progress towards understanding and intervening in associations between stigma and health inequities. We situate time in relation to key concepts in stigma research, identify three timescales that are relevant for understanding stigma (historical context, human development and status course), and outline a time-based research agenda to improve scientists’ ability to understand and address stigma to improve health.

Background The unprecedented rapid development of COVID-19 vaccines has faced SARS-CoV- (COVID-19) vaccine hesitancy, which is partially fueled by the misinformation and conspiracy theories propagated by anti-vaccine groups on social media. Research is needed to better understand the early COVID-19 anti-vaccine activities on social media. Methods This study chronicles the social media posts concerning COVID-19 and COVID-19 vaccines by leading anti-vaccine groups (Dr Tenpenny on Vaccines, the National Vaccine Information Center [NVIC] the Vaccination Information Network [VINE]) and Vaccine Machine in the early months of the COVID-19 pandemic (February–May 2020). Results Analysis of 2060 Facebook posts showed that anti-vaccine groups were discussing COVID-19 in the first week of February 2020 and were specifically discussing COVID-19 vaccines by mid-February 2020. COVID-19 posts by NVIC were more widely disseminated and showed greater influence than non-COVID-19 posts. Early COVID-19 posts concerned mistrust of vaccine safety and conspiracy theories. Conclusion Major anti-vaccine groups were sowing seeds of doubt on Facebook weeks before the US government launched its vaccine development program ‘Operation Warp Speed’. Early anti-vaccine misinformation campaigns outpaced public health messaging and hampered the rollout of COVID-19 vaccines.

Black sexual minority men in the southern United States continue to experience pronounced disparities related to the human immunodeficiency virus (HIV) and other sexually transmit- ted infections (STI). HIV/STI stigma undermines outcomes along the HIV and STI care continuums, and exacerbates HIV/STI disparities. Identifying who is at greater risk of experiencing HIV/STI stigma following diagnosis could inform targeted intervention efforts to address stigma and improve outcomes among vulnerable individuals. The current study therefore explored associations between sexual orientation outness and HIV/STI stigma in the first year post-HIV/STI diagnosis among Black sexual minority men in the southern United States. Data were drawn from a longitudinal study of 151 participants followed for the year following an HIV/STI diagnosis. Outness was measured before HIV/STI diagnosis, and HIV/STI stigma was measured monthly following diagnosis. Data were analyzed with multilevel models. Participants who were not fully out experienced greater internalized, enacted, and anticipated HIV/STI stigma immediately following their diagnosis than participants who were fully out. Moreover, outness moderated the trajectory of internalized HIV/STI stigma over the first year post-diagnosis: Participants who were not fully out initially experienced a faster decline in internalized HIV/STI stigma as compared to participants who were fully out. Findings suggest that Black sexual minority men who are not fully out may be particularly vulnerable to HIV/STI stigma following their diagnosis. Targeted intervention efforts could address HIV/STI stigma among vulnerable individuals during this time-period that is critical for linkage to and engagement in HIV/STI care.